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MEDICINES are essential for the sick or injured, and can be a matter of life and death. It is not an ordinary commodity but a necessity for survival or recovery.
However, access to life-saving medicines can face the barrier of affordability because, unfortunately, medicine pricing in Malaysia is currently totally unregulated.
A 2019 study by University of Malaya revealed that 72% of cancer patients experienced financial catastrophe during the first year of treatment in private hospitals, while one-third of households became impoverished.
Cancer medicines are very well known to have exorbitant price tags, and mark-ups by the private hospitals on the originator drugs and generic drugs are also well-studied. Affordable medicines are a challenge if we leave it entirely to the market.
In April 2019, the cabinet approved the Medicines Price Mechanism policy proposal tabled by the Health Ministry (MOH) in collaboration with the Domestic Trade and Consumer Affairs Ministry. Under the first phase of the policy implementation, the government will impose an upper limit of mark-ups at the wholesale and retail levels in a regressive manner (higher priced items will have a smaller mark-up for the upper limit), for about 600 single-sourced prescription medicines. But almost three years later, the policy still has not yet been implemented.
Recently, I was shocked to discover that certain vested interests in the private healthcare and pharmaceutical sectors, who have strong objections to the policy, managed to persuade the International Trade and Industry Ministry (Miti) to have a go at conducting a cost-benefit assessment (CBA) on the medicines pricing policy’s impact on private healthcare.
On November 29, the preliminary findings of the study were uploaded to the UPC (Unified Public Consultation) website of the Malaysian Productivity Corporation (MPC). The presentation of the findings was conducted via Zoom using the Webinar format on December 1, in which participants were restricted to typing questions in the Q&A box without being able to see each other’s questions or find out who else was present in the meeting.
The so-called public consultation lasted about one hour, with many questions left unanswered or not adequately addressed. Some participants resorted to the Zoom Chat box to share their comments.
One of the most pertinent questions is the identity of the so-called Third Party Independent Consultant and the funder(s) behind the study. It was not revealed throughout the meeting nor in the document despite being repeatedly asked by a number of participants. What is the point of having public consultation then?
What I found most troubling was the direct involvement of the major private sector players in the steering committee and technical committee for this CBA study: the Pharmaceutical Association of Malaysia (Phama) comprising multinational companies, the Malaysian Organisation of Pharmaceutical Industries (Mopi), the Association of Private Hospitals of Malaysia (APHM), Malaysian Medical Association (MMA) and even the Pharmaceutical Research & Manufacturers of America (PHRMA) – they all have direct interest in stopping or reversing the new policy.